| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
934 |
926 |
$51K |
| A7031 |
Replacement facemask interfa |
686 |
679 |
$28K |
| A7030 |
Cpap full face mask |
252 |
248 |
$27K |
| A4604 |
Tubing with heating element |
559 |
552 |
$25K |
| E0562 |
Humidifier heated used w pap |
424 |
424 |
$15K |
| A7035 |
Pos airway press headgear |
372 |
370 |
$9K |
| A7038 |
Pos airway pressure filter |
1,083 |
1,070 |
$5K |
| E0570 |
Nebulizer with compression |
121 |
107 |
$3K |
| A7046 |
Repl water chamber, pap dev |
140 |
140 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
28 |
26 |
$216.53 |